TO DETERMINE THE FREQUENCY OF VISCERAL LEISHMANIASIS IN PERIPHERAL CYTOPENIC PATIENT IN PATHOLOGY DEPARTMENT HAYATABAD MEDICAL COMPLEX.

Abstract

BACKGROUND: Visceral Leishmaniasis is a chronic disease and was first described in 1903, by
LIESHMAN and DONOVAN. The disease is common in tropical and sub tropical areas of the world
with various hematological manifestations. It is characterized by fever, visceromegaly, weight loss,
pancytopenia and hypergammaglobulenemia. The disease is silent killer, invariably killing almost all
untreated patients, but curable with hematological improvement within 4-6 weeks of treatment.
OBJECTIVE: To determine the frequency of Visceral Leishmaniasis in patints with cytopenias .
MATERIAL AND METHODS: A descriptive study conducted in Pathology department, Hayatabad
Medical Complex, Hayatabad from September 1, 2012 to August 31, 2013. This study comprises of 126
patients, subjected to complete blood counts. Diagnosis were confirmed by finding Amastigote( L/D
body) from bonemarrow aspirate. All the patients who were referred to pathology Department of the
hospital for bone marrow examination, with the results of peripheral blood using automated
Haematology analyzer, Sysmex KX 21 showing cytopenia were included in the study. Consent was
taken from the patient for bone-marrow aspiration procedure. After consent detailed history, physical
examination was done.
Laboratory investigations i.e. full blood count, which includes hemoglobin estimation, white blood cell,
red blood, and platelet count.
Bone marrow cytology (Giemsa stain) was recorded on the designed profroma.
Posterior superior iliac spine (PSIS) was used as the site for aspiration in adults and children over 2
years of age
RESULT: Descriptive case series study of 126 patients of peripheral cytopenia. In which 77 (61.1%)
patients were males and 49 (38.9%) were female with male to female ratio of 1.57: 1 It was also found
in this study that visceral leishmaniasis was present in 29 (23%) of cases and the male: female were 1.6:
1. Result of the automated hematology analyzer of peripheral cytopenic patients in visceral
leishmaniasis show that all of the patients were having total leukocyte count less than 4000/cmm
(100%). The hemoglobin level wass less than lOgm/dl in 26 cases (87.7%) and more than lOgm/dl in
three cases (10.3%). In case of platelets count, 27 cases (93.1%) were having platelets count less than
150000/cmm.
CONCLUSION: Incidence of visceral leishmaniasis is highier in children age group 1-10 years, also
males are more prone than females. Leukopenia is recorded in all (100%) of the cases, followed by
thrombocytopenia (93.1%) and anemia (Hb <10gm %) 87.7% cases.
KEY WORD: Visceral Leishmaniasis, Kala Azar, Amastigote (L/D body)